• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Vitamin D receptor activators may not reduce cardiovascular risk in patients undergoing hemodialysis.

byJason Nam, MDandDaniel Fisher
December 18, 2018
in Cardiology, Chronic Disease, Nephrology
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. In this randomized clinical trial, patients on hemodialysis who received a vitamin D receptor activator (VDRA) did not have better cardiovascular health compared to those with placebo.

2. Patients receiving active vitamin D did not have reduced mortality.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Patients with advanced chronic kidney disease (CKD) on hemodialysis are at greater risk for cardiovascular disease, and impaired activation of vitamin D by the kidneys may contribute to this increased risk. Though studies have shown benefits of vitamin D receptor activators (VDRAs) like alfacalcidol for reducing cardiovascular risk, it is not clear if they reduce risk in CKD patients on dialysis. In this open-label, randomized controlled trial, patients on dialysis who received oral alfacalcidol did not have reduced risk of composite cardiac events compared to controls. In addition, there was no difference in mortality between groups. The number of adverse events were similar.

Unfortunately, these results are in line with previous studies such as PRIMO and OPERA that showed that oral paricalcitriol did not have cardiovascular benefit. Though the control group was allowed to take VDRAs if mandated by guidelines, suggesting one confounding factor, the investigators attempted to address this issue by selecting patients with intact PTH levels. In addition, post-hoc power analyses suggested the study may have been underpowered to sufficiently detect differences in the primary and secondary outcomes.

Click to read the study in JAMA

Relevant Reading: Analysis of the kinetics of the parathyroid hormone, and of associated patient outcomes, in a cohort of haemodialysis patients

RELATED REPORTS

Improved mortality rates for myocardial infarction, stroke, and pulmonary embolism in patients receiving dialysis between 1998 to 2015

Spirituality-oriented psychological counseling may reduce fear of death among hemodialysis patients

Wellness Check: Spirituality

In-Depth [randomized controlled trial]: In the Japan Dialysis Active Vitamin D (J-DAVID) trial, 976  patients with CKD on maintenance hemodialysis with intact PTH levels (less than or equal to 180 pg/mL) were recruited from 207 Japanese dialysis centers from 2008 to 2011. They were randomized 1:1 to receive 0.5 µg of oral alfacalcidol or care as usual. The control group was asked to avoid other VDRAs but was allowed to receive them if warranted by guidelines of the Japanese Society for Dialysis Therapy. The primary outcome was a composite of fatal and nonfatal cardiovascular events, including myocardial infarction, congestive heart failure requiring hospitalization, stroke, aortic dissection/rupture, amputation of ischemic limb, sudden cardiac event, coronary interventions, and lower limb artery interventions. The secondary outcome was all-cause death. During a median follow-up of 4.0 years, the primary outcome occurred in 103 patients (21.1%) in the intervention group and 85 patients (19.9%) in the control group (absolute difference 3.25%; CI95 -1.75% to 8.24%). There was no significant difference between the intervention and control group in the secondary outcome of all-cause death (HR 1.12; CI95 0.83-1.52). The adjusted hazard ratios for the primary outcomes were 1.32 (CI95 0.96-1.82) and 1.34 (CI95 0.97-1.83) when the per-protocol set and the modified per-protocol set were analyzed. The numbers of significant adverse events were also similar between both groups.

Image: PD

©2018 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: hemodialysis
Previous Post

Patients with low back pain or pain at multiple sites at highest risk for chronic opioid use

Next Post

Daily medication more cost-effective than monthly injections for opioid use disorder

RelatedReports

Fish oil and aspirin did not reduce arteriovenous fistula failure: The FAVOURED trail
Cardiology

Improved mortality rates for myocardial infarction, stroke, and pulmonary embolism in patients receiving dialysis between 1998 to 2015

April 22, 2022
Fish oil and aspirin did not reduce arteriovenous fistula failure: The FAVOURED trail
Nephrology

Spirituality-oriented psychological counseling may reduce fear of death among hemodialysis patients

March 28, 2022
Association of Use of Oral Contraceptives With Depressive Symptoms Among Adolescents and Young Women
Chronic Disease

Wellness Check: Spirituality

March 24, 2022
Novel coronavirus identified from patients with pneumonia in Wuhan, China
Chronic Disease

Poor humoral response observed in patients undergoing hemodialysis following a single dose of the BNT162b2 SARS-CoV-2 vaccine

September 7, 2021
Next Post
Quick Take: Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

Daily medication more cost-effective than monthly injections for opioid use disorder

No association found between length of storage for transfused red blood cells and patient mortality

Data supports limiting blood transfusions for moderate anemia

Paternal factors associated with short interpregnancy interval

Risk of malformations in offspring likely minimal with use of ondansetron (Zofran) in first trimester

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

Get 2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • #VisualAbstract: Severe actinic keratosis and need for additional treatment are markers for an increased risk of cutaneous squamous cell carcinoma
  • Virtual yoga and meditation intervention may be associated with increased health-related quality of life
  • Wellness Check: Mental Health
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.